The report, “Medicare: Trends in Beneficiaries Served and Hospital Resources Used in Implantable Medical Device Procedures,” includes data on orthopedic and cardiac IMD procedures performed on Medicare beneficiaries from 2003 through 2009. GAO studied IMD hospital admission rates, hospital lengths of stay and discharge disposition for primary elective total knee, hip and shoulder replacements; lumbar fusions; and drug-eluting stents, automatic implantable cardioverter defibrillators and dual-chamber pacemakers. Lumbar fusion procedures were defined as primary elective initial lumbar or lumbosacral fusion with a posterior technique.
While orthopedic IMD admissions increased for all procedures studied, cardiac IMD admissions were more varied. AICD admissions increased from 2003 to 2006 and then declined through 2009. In contrast, dual-chamber pacemaker admissions decreased steadily over the seven years.
Orthopedic IMD hospital admission rates had the following average annual increases from 2003 through 2009:
• Knee replacements — 6.7 percent.
• Hip replacements — 4.1 percent.
• Shoulder replacements — 20.1 percent.
• Lumbar fusions — 11 percent.
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